Archive for Interpersonal Neurobiology

Trauma is a word that gets tossed around more often now but do we really understand what trauma is? It turns out that there are different kinds of trauma but they all have one thing in common: The capacity to manage what is experienced has been exceeded and this person is stuck in perpetual pain not knowing how to resolve the flood of feelings and thoughts that are running amok inside them.

If you aren’t prepared then you’re left feeling powerless and confused.

Trauma happens to us when what we experience cannot be integrated or understood and our nervous system is overloaded to the point that is shuts itself down and takes our brain and nervous system offline. When this happens the part of the brain that enables us to make meaning of what is happening and integrate it so that our nervous systems recognizes we are safe and OK is temporarily disconnected from the rest of the brain. This is basic hard-wiring and what has kept us safe since human life began.

For some lucky people who have not experienced much or any trauma, this system is used less. For others, it has been the norm throughout their lives and, where it once helped, now more often tricks us or causes more problems.

Basically when we experience a trauma trigger we are in a state of fear and the part of our brain that allows us to create context and meaning out of what we experience – the pre-frontal cortex – is no longer available. It has been taken offline so that all remaining function can be directed toward safety and survival.

This type of event can occur in one extreme shock or it can occur over time by the accumulation of many momentary threats and wounding that reinforce the feeling of being unsafe.

Think of it as one BIG “T” or a mountain of little “t’s” the result of which is overload, shutdown and trauma.

So that happened now what do I do?

Well, trauma is a package deal because it comes with TRIGGERS. These are reminders and familiar things that we recognize – sometimes consciously, sometime unconsciously, as familiar and “like the trauma” but to another person witnessing it in this time and place, it may not appear like anything traumatic at all. It can be very confusing.

One of the most difficult challenges for someone who has experienced trauma is the feeling that no one understands or believes them.

For the person experiencing the traumatic trigger, it does not matter one hoot to their brain and nervous system that other people aren’t seeing the same thing – they feel it as true. The physical body merely alerts us and because the brain was unable to create meaning at the time the trauma occurred, time and place become irrelevant and it is true as much now as when the trauma really happened no matter how long ago.

The best metaphor that I use with my clients is to think about trauma as a disease just like diabetes and the triggers like sugar. For someone who doesn’t have diabetes all the sweet things are just fine and no problem at all. But to someone with diabetes, a little bit of sugar is life threatening.

It’s the same thing for a trauma trigger. Common every day slights and upsets would be easily brushed off by someone who doesn’t have the triggers. But for someone carrying trauma, it sends us into shock and we need something added to bring our system into balance. For a diabetic it is insulin. For traumatic trigger recovery it is attunement and acknowledgement – validating the feelings and naming them that creates a sense of calm and safety.

As Dr. Siegel says, name it to tame it.

So this brings us to you – friends and family of someone you love and who carries trauma.

It is very confusing to us when someone we love lashes out at us for seemingly no reason or freezes and withdraws or abruptly gets up and walks out. The behavior feels deliberate and hurtful to us*.

So what happens is misunderstanding and further withdrawal and trauma – now passed between each other and reinforcing that the world is not safe and I am not safe with you.

What can we do?

Well, first thing is to recognize that the person is struggling with something they cannot control. They may work very hard to manage it but until real healing occurs and the trauma is integrated as meaningful and contextualized life experience they will fall short. So when triggering occurs, they slip into the least helpful behaviors that make you not want to be near them.

“Allow this behavior to be accepted as a temporary bump in an otherwise loving road.”

The following are suggestions to help you and your loved one have tools to break the cycle of re-traumatization and form deeper connection for healing in the relationship:**

Step 1: Don’t personalize.Recognize that this person you love does not want to hurt you, but is triggered and needs your help to regain a sense of safety.

What you see – my sister is yelling at me/him/her, my brother is leaving the dinner abruptly, my mother is crying, my father has a glazed look in his eyes and doesn’t seem to hear me.

What they see/feel – I am not safe here, I am not wanted, I don’t belong, a barrage of negative self talk and a flood of emotion or perhaps just fog and numbness.

What they need to hear – It’s OK, I am here and I want to understand what is happening right now. What do you need? Tell me what you are feeling? How can I help you?

Step 2: ListenTo the capacity you can, just listen. If you can’t stay present for whatever reason, let them know you love them but need to take a moment (good modeling) and that you will be right back.

Acknowledge their feelings and reflect what you heard – keeping your voice relaxed and low and, above all, remaining calm. You may hear blame or other messages that make you uncomfortable. They may express exaggerated feelings or emotions – things that seem nonsensical to your own experience of what is happening. Above all don’t argue or contradict them. Just keep listening.

Acknowledgement does not mean you accept blame – but you can say “I understand” and “I appreciate you telling me.” with the intention to talk more later.

It will take some time for them to calm down depending on the trigger and the circumstances. Allow them to step away and recover, or hold them close and let them cry, or give them space but stay present with them. To the capacity that you can, give them what they ask for. Above all listen. The objective is to attune to them and love them through this moment into safety and calm.

Step 3: Believe Them
What they say may trigger some feels of your own and you may feel the impulse to defend. Try not to because this is not about you and it won’t help anyway. Let them know you believe what they say is true. This doesn’t mean you agree or align with their point of view, but you are allowing them to have the experience they are having without shame or judgment and this is a very important element to the healing process. You may also gain insight which allows you to see their pain and have deeper empathy. Remember even members of the same family can have very different experiences of the shared relationships and events.

Step 3: Problem SolveAfter you have listened to what they feel and need it is important to back it up with real behavior change. Talk with them about how to help them avoid the trigger in the future. Listen to what is causing them pain and hold the request with appropriate concern and urgency. Negotiate a solution and adaptation where you see opportunity for that.

Step 4: Be an allyEncourage and model for others in the family or community how to remain calm and manage it when future events occur. Allow this behavior to be accepted as a temporary bump in an otherwise loving road. By doing that you will find that the person will gain a sense of trust in the connection and feel triggered less frequently as a result.

Recognize that although their behavior makes you uncomfortable and anticipating their moods can impact your own enjoyment of the community or family – the best way to correct it is to deepen the connection with them, if possible. Allowing them to have their experience and you sharing yours. Giving each other a chance to understand the differences and shared perspectives.

Most importantly, avoid the temptation to scapegoat or join in conversation about the person that furthers the negative stories about them. These stories reinforce that they really are unsafe and erode trust for everyone.

The more shame and judgment allowed, the less safe people feel.

Notice common ways of relating in your family or community that may be contributing to the dysfunction and impacting everyone as a result. Remember we all play a role in the health of every relationship, family or community in which we are a member.

*Of course it hurts and it is important you know that your feelings matter too and must be acknowledged but for the sake of healing the time for that is when things are calm not in the middle of the triggering event. If you are triggered yourself, then seek support first!

**DISCLAIMER: These suggestions are intended to assist with mild to moderate triggering events where emotions are the primary expression. If you feel you or the other person is in immediate physical danger – call 911.

White House intern Monica Lewinsky has recently returned to the spotlight after decades of obscurity to share her personal experience of bullying and public shaming. If you’re too young to know who she is here is her biography and an overviewof the scandal that precipitated her becoming, for a time, one of the most recognized and reviled women in America.

She was 22 years old and too young to realize the consequences of her actions when she “fell in love with her boss” who, unfortunately for her, was also a man, who at more than twice her age, didn’t seem to care about the consequences their actions would have for either of them.

These many years later, she is finally ready to reclaim her narrative and that is why her story is so meaningful to me and the work I do. People who have been targeted for bullying, shaming and abuse are always left feeling that their story has been stolen and distorted and struggle with how to overcome the powerlessness of feeling so betrayed.

The truth will set you free, but first you have to reclaim it.

When shame is being served, it is always served with contempt and humiliation. Humiliation is one of the most painful things anyone can experience. It is a betrayal of all trust and the person targeted is left confused and struggling to regain their ground amid a fiction where they are guilty and don’t even know the crime.

Children are especially vulnerable because their sense of self and identity is still forming. A child’s brain development doesn’t finish until about age 25. The last part of the brain to mature is the executive functioning area of the brain in the prefrontal cortex. This is the part of the brain that enables problem solving and recognition of future consequences. So at 22, Monica was still developing and was not much more than a child herself.

Thanks to a “friend,” turned betrayer, Monica was cast into the public spotlight and the result was a universal public shaming. This was before the internet so she was spared the instantaneous reaction of “mobbing” but today’s kids are not so fortunate. We have seen countless suicides by children and young adults who cannot imagine that there will come a day when they will no longer feel so alone, isolated and vilified.

These were kids and they were directly harmed by other young people. They were also indirectly harmed by adults and bystanders who minimized and ignored the abuse. As a result they were publicly shamed to death. If they knew that time would heal their emotional wounds and that things would get better, they might still be alive.

Like Monica, they experienced the extreme ways that shaming and bullying can be wrought on people who are unlucky enough to be in the line of sight of someone who would take advantage of the opportunity to shame. When someone creates a story about us that involves shame, then you know that there is something wrong with that story.

I know I’m a good person

Our story is our identity and what grounds us and sets the course for our life. It impacts the people we choose to spend time with and what we see when we look in the mirror. Our story tells us about our goodness and our strengths and how flawed we are and whether those flaws are obvious enough to allow us to be loved. Am I enough? Am I good? Do I deserve to be treated this way?

If you have been emotionally abused or bullied as a child then it is hard to know because the information that shaped the story of YOU is not trustworthy. How do you know what is you and what is not you? One measure I have learned to use is this: Is there shame? If the answer is yes – then it is not good information. If the answer is no then I stay curious and ask for more clarification. If you were shamed by your parents then the work to recover and undo those narratives is long, but worth every minute to reclaim your right to exist and your right to be happy.

People who abuse and bully use shame and contempt as a means to push you down in order to elevate themselves. It isn’t funny and it isn’t truth. It is abuse.

Every good story has a beginning, a middle and an end. The best stories have a long middle. Monica stayed alive and now she is recovered and is healing. It took a long time. It always takes a long time but that is what makes a good story. Now her story includes using the trauma from her past to help others and to create change. Her story keeps getting better and better.

If you have suffered from early life trauma or abuse, what will the rest of your story be? Keep going, keep moving toward the things and people who make you happy and, above all, keep living.

The common answer is that some people identify with victim-hood as a way of avoiding responsibility for their own lives. Some people just like to be abused and get some kind of pleasure from it. For kids, it’s part of their social development to learn how to live in a tough world.

These are all outdated and easy catchall explanations that blame the target and allow bullies and tyrants to continue to abuse with impunity. We know that abuse is wrong and thankfully we are slowly gaining legal ground that offers protection and accountability. But we still want to blame the target. Why?

The biggest reason, in my opinion, is that this is the easiest answer available that absolves us of the conflict we want to avoid. If we admit that the bullies and tyrants are the problem, then we have to do the hard work of confronting the reality, or worse, the bullies themselves. We have to file the police report, talk to the principle, and provide a safe haven for someone knowing that we now have our skin in the game. It is easier to be a bystander and attribute the control to the person we could never be – a victim.

People avoid conflict as much as they can because we haven’t been taught how to fight fair. We don’t know how to take on the bad guy. And worse, sometimes the bad guy is someone we know or even love. It’s just so much easier to think that this person who is nice to me would only treat you that way because you deserve it, asked for it, wanted it.

So what do we do?

First – let me repeat the premise that victim mentality is a myth. People do not choose to be abused. They adapt to it and learn to exist in and around it in order to survive. Depending on their age and level of brain development they initially go into shock and then their brains adapt. This adaptation is now being studied as part of a new field of brain research called Interpersonal Neurobiology.

What this new field of brain research is showing us is that the brains of people who experience trauma adapt in a way that makes them further vulnerable to abuse. It is not a conscious choice to stay in an abusive situation. The part of the brain that enables us to use reasoning and the capacity to problem solve is literally taken offline during times of high stress and trauma. And when this is repeated over weeks or years, especially in childhood, parts of the brain can literally be damaged.

Why do people who are in abusive relationships stay in them?

Why don’t battered women leave?

Why doesn’t a kid who is bullied just hit back?

It is because they have not yet developed or have lost the capacity to solve the problem themselves. They are locked in a room with a terrorist and they can’t even see the door.

They need our help. Most importantly, they need our compassion and understanding. Someone who is battered, abused, bullied is not enjoying the experience. They don’t deserve it. They want things to change.

Now that you know that, what will you do next time?

If you are interested in learning more about Interpersonal Neurobiology: